超声引导下的细针穿刺活检在腮腺肿瘤中的诊断价值的系统评价和Meta分析
首发时间:2013-03-07
摘要:目的 评价超声诱导下细针穿刺活检(Ultrasound-guided fine-needle aspiration,USFNA)在腮腺肿瘤术前诊断中的价值。 方法 检索中国生物医学文献库,Medline,Embase收集相关文献,使用QUADAS评价标准(quality assessment of diagnostic accuracy studies, QUADAS)对文献质量进行评价。所有过程均由两名研究者独立完成,不同意见通过讨论解决。使用MetaDisc1.4完成Meta分析。 结果 10篇文献符合纳入标准。Meta分析结果显示超声引导下细针穿刺活检分辨腮腺肿瘤良恶性的合并诊断指标及其95%可信区间如下:特异度0.99(95%CI: 0.98-1.00),敏感度0.86(95%CI: 0.78-0.91),阳性似然比42.39(95%CI: 22.03-81.57),阴性似然比0.20(95%CI: 0.13-0.29),受试者工作曲线下面积0.9830。 结论 超声诱导下的细针穿刺活检在腮腺肿瘤的良恶性鉴别中具有较高的特异度和敏感度,可以作为常规术前检查之一。应注意穿刺的方法,穿刺后并及时安排手术治疗。
关键词: 腮腺肿瘤 超声诱导下的细针穿刺活检 敏感度与特异度
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Ultrasonography Guided Fine-Noodle Aspiration Cytology for Parotid Tumors:a Systematic Review and Meta-analysis
Abstract:PURPOSE To evaluate the diagnostic value of ultrasound-guided fine-needle aspiration(USFNA) in differentiating malignancy and benign lesions of the parotid gland. METHODS The diagnostic studies on ultrasonography guided fine-needle aspiration cytology for parotid tumors were searched through CBM、Medline and Embase. The methodological quality was assessed with quality assessment of diagnostic accuracy studies (QUADAS). Two reviewers took part in all of the work in duplicate and any disagreement was resolved by discussion. Meta-analysis was done with MetaDisc1.4. RESULTS A total of 10 studies were included. The results of meta-analysis showed the pooled diagnostic values and its 95^%CI in differentiating malignant and benign tumors in the parotid gland as following: specificity 0.99 (95%CI: 0.98-1.00), sensitivity 0.86 (95%CI: 0.78-0.91), positive likelihood ratio 42.39 (95%CI: 22.03-81.57),negative likelihood ratio 0.20 (95%CI: 0.13-0.29),the area beneath the ROC curve was 0.9830. CONCLUSION The ultrasonography guided fine-needle aspiration cytology showed a high specificity and sensitivity in differencing the malignant and benign tumor of the parotid region, which should be used as a routine test before operation.
Keywords: parotid gland neoplasms ultrasound-guided fine-needle aspiration sensitivity and specificity
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超声引导下的细针穿刺活检在腮腺肿瘤中的诊断价值的系统评价和Meta分析
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